Making vital connections

By Zhang Zhilong Source:Global Times Published: 2012-8-19 21:00:03

With the help of Gao Min (left), a professional organ donation coordinator, Liu Youxue fills out a form to donate her husband's corneas and body in Shenzhen on August 25, 2010. Liu's husband died a year later at the age of 92. Photo: Courtesy of Gao Min

In her seven years of coordinating organ donations in Shenzhen, Guangdong Province, Gao Min has been mistaken for an organ dealer more than once.

"But most people now are beginning to understand what I am doing. They also ask me to send their best wishes to donors' families," she told the Global Times. As one of about 500 licensed organ professionals nationwide, Gao has connected dozens of patients with donors in a country where people are still uncomfortable with the idea of organ donation.

Working for the Red Cross Society of Shenzhen, Gao is not only in constant search for potential donors, but also busy communicating with relatives about the process, comforting families after operations and spreading organ donation awareness.

Although progress is slow moving, Gao believes more people will make the decision to become donors in the future and help give the gift of life.

On May 13 this year, or Mother's Day, Gao helped guide Yuan Dezhen through the process to donate her son's organs, a move which later saved five lives.

A car accident in Shenzhen had killed Yuan's husband while leaving her 11-year-old boy in a coma for four months. Doctors had little hope her son would wake up.

Yuan, 40, from Guizhou Province, said she made the decision to take her son off life support one night after he visited her in a dream. "Mom, I think I'm leaving you. Please let me go," Yuan said, recalling her son's words.

"I don't regret the decision and I don't care what people say about me," she said, adding that she knows she has done a good deed.

Meaningful job

Gao Min said she has been moved by every donor she has met. Yuan chose Mother's Day to donate the organs bacause "it's a meaningful day," said Gao to the Global Times.

Gao still remembers clearly the first donation she worked on. It was the first donation case in China where several organs from the same individual were donated for free.

Back to September 2005, a woman from Hubei Province turned to Gao for help. Her name was Wang Lei, a migrant worker in Shenzhen whose 18-year-old daughter, Jin Xing, had died in a car accident. "If other people could survive or live a better life after getting my daughter's organs, that would be a sort of comfort for me," she told Gao. Jin Xing's liver, kidneys and corneas went to help patients in Shenzhen, Shanghai and Wuhan, according to media reports.

Gao's job is not finished after the operations are performed. Her role is also to comfort families and to guide them through this very emotional process.

"I cannot help dreaming of my daughter every night. She asked me to take a look at her," Gao recalled what one mother told her, after calling her at midnight. "I regret the donation, could you please give me my daughter back?" cried the mother several days later.

Gao said the mother, who had donated her 6-year-old daughter's organs, was distraught and needed comforting.

Unsuccessful cases

Gao has also seen her share of unsuccessful cases. One of them involved a 40-year-old migrant worker from Guizhou Province who was dying from a cerebral hemorrhage. He could have been a donor but his family wanted too much money for his organs, charging between 60,000 yuan ($9,430) and 100,000 yuan, Gao said.

"I am in debt after building a house. How can I pay it back? I would not donate his organs if I wasn't in debt," said the man's wife. This infuriated Gao, who told the woman she was trying to "sell" organs, which is illegal in China.

This type of procedure is very important and decisions cannot be reversed, since families trying to set prices for organs could lead to organ trading instead of donations, Gao cautioned.

However, families that are in dire financial straits can receive subsidies after the donation. "But first they must apply for financial assistance, and their application must be presented to the Red Cross Society," said Gao, adding that no promises of compensation can be made to families.

Concerning donations, difficulties are everywhere not only for coordinators, but also for doctors. Yang Chunhua, director of the ICU at the First Affiliated Hospital of Sun Yat-sen University in Zhongshan, Guangdong Province, remembers the case of a 30-year-old man who had died in a car accident.

The police had approved the transfer and the family was willing but the legal examiner simply refused to allow the donation to go through.

Donor families can also be deeply moved by the experience. "If I could have the chance to visit one of the receivers, I would definitely do so. I would bring some fruit as I would for my son," said Yuan, although she knows that policy dictates she cannot meet the receiving families.

China is following international practices which don't allow donors to meet receivers in case of unexpected troubles, explained Yang.

"If they met each other, receivers might feel guilty and we don't know what would happen in the future," said Yang, adding that one girl's parents did not donate her organs simply because they were not allowed to meet the receiving patient.

Sore need for communication

For Yang, the current system gets in the way. There is no reporting done within a hospital or between different hospitals about organ availability.

He said many hospitals in rural areas have potential donors, but they are not qualified to perform organ transplants and it is hard for doctors in big hospitals to get the information.

"If a report system is established, we could share information and get more organs for patients," sighed Yang.

His view is shared by Liu Hong, a part-time coordinator and nurse at the Second Hospital of Shandong University in Jinan, Shandong Province. "If I didn't go to the ICU to ask doctors, I wouldn't know what organs are available. But doctors are not always happy to be asked," said Liu, adding that her enquiries sometimes anger doctors who feel they are being reproached for not saving lives.

She says an information sharing system would improve her job efficiency and save lives.

Having taken the job since October 2010, Liu had not succeeded in completing a donation until March of this year. "The job is sensitive, and must be done cautiously," recalled Liu of what her boss told her two years ago.

Organ donations are sensitive and are new for Chinese people, said Wang Ping, director of the Relief & Health Department under the Red Cross Society of China.

Just at beginning stage

Only 16 provinces and municipalities were originally chosen for a pilot program for organ donations, according to Wang. Chongqing Municipality, Anhui and Shanxi provinces have recently been added, taking the total up to 19.

The program began in March 2010 when coordinators began to be trained for their position, according to Wang. He said more than 500 coordinators have been trained and are working in these pilot areas. Among them, Gao Min is different because she took up her position much earlier than most of her peers.

"This area is just at its beginning stage, and we must make thorough preparations before promoting organ donations nationwide," said Wang.

In these 19 pilot areas, local governments can choose whether or not to promote the program and which places would participate.

"We don't enforce any quotas of the donations in place for them," Wang explained, adding that this had partly led to the current lack of organ donors.

He said the job needs cooperation between health departments, medical organizations and Red Cross societies.

Wang sees the US as an example as it has 53 OPOs (organ procurement organization) across its 50 states, some of which have over 300 trained staff. "Similar organizations should be built in China," he said.

It takes time

Some people blame Chinese traditional customs for preventing people from donating organs, but to coordinators and officials, different individuals have different circumstances and choices.

"Donors should be praised, but those who don't donate should not be criticized," said Wang Ping, a view echoed by both Gao and Liu.

To Liu, it will take time for people to accept this concept.

Recently, a 37-year-old man died after an accident on a construction site in Jinan. His organs were donated, and his wife received around 40,000 yuan in compensation after Liu informed the local Red Cross Society about the case. "I wanted to donate my husband's organs, but I dared not speak out about it. People might have thought I was selling them," the wife told Liu.

Yang said that 95 percent of families who donate organs are poor ones like that of Yuan Dezhen, who earned about 5,000 yuan a month with her husband in Shenzhen before the accident.

As indicated by Liu's story, they may also face widespread speculation that they are selling organs for small fortunes, given the pressing market demand.

One case in particular moved Wang, who had tears in his eyes as he told the story to the Global Times reporter. One villager donated his daughter's organs for free, but his neighbors refused to believe he would do so for free.

Every year about 1.5 million patients need organ transplants in China, but less than 400 donation cases have been recorded since March 2010, according to Wang.

Gao said she often gets phone calls from people who offer to sell organs at a price. Callers ask her how much she pays for a kidney but she is forced to turn them away, telling them that organ trading is illegal.

Although it may seem they are facing rough conditions, the coordinators remain optimistic and are confident about the future of their jobs.

Liu noted she has arranged several successful cases after March and believes donor numbers will climb.

Gao said 60 donation cases so far came through her. "There would be no donations if there were no coordinators," said Wang.